Provider
QP80-20 MHCP Pharmacy Benefit Update - AvsolaTM, Ilaris® and PerserisTM
Program effective Date: Aug 26, 2020
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Provider
Reduction Mammoplasty Commercial Pre-Authorization Request Form (Medical Policy IV-32) (PDF)
Provider
P28R1-20 Update: Medical Oncology Drug Prior Authorization Updates for Fully Insured Commercial and Medicare Advantage Subscribers – eviCore Healthcare Specialty Utilization Management (UM) Program
Program effective Date: Aug 03, 2020
Provider
P57-20 Site of Service Program Updates for Selected Specialty Medical Drugs for Commercial Subscribers: Medical Policy XI-06
Program effective Date: Aug 03, 2020
Provider
QP73-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Bempedoic Acid PA with QL
Program effective Date: Aug 12, 2020
Provider
QP72-20 MHCP Pharmacy Benefit Update – Pharmacy Benefit Exclusion for Anjeso™, Fetroja®, Herzuma®, Ontruzant®, Potassium Phosphates, Scenesse® and Trazimera™
Program effective Date: Aug 12, 2020
Provider
QP71-20 MHCP Pharmacy Benefit Update: Pharmacy Benefit Exclusion for Phesgo™, Uplizna™, and Zepzelca™
Program effective Date: Aug 12, 2020
Provider
P63-20 Prior Authorization Updates for Skilled Nursing Facility Admissions
Program effective Date: Aug 03, 2020